The main periodontal diseases are :
Gingivitis is the initial form of periodontal inflammation, which affects only the gum (gingiva), while the bone around the tooth remains healthy.
With early treatment, the patient recovers completely.
The treatment of gingivitis includes information about the causes of the patient's disease, individual training for brushing teeth, several treatments (1 to 4) to eliminate the bacteria causing the disease, and the prescription of necessary medical solutions for rinsing.
Cured patients are provided with an individual plan for further care of the gums.
Periodontitis is an advanced form of periodontal disease that affects the bone around the tooth.
Following the diagnosis and assessment of the disease’s progression, the treatment of periodontitis is organized in three stages:
- Primary (etiological) treatment: it is the most important part in the treatment of periodontitis because it leads to the elimination of the harmful bacteria in the oral cavity environment and the rest of the disease-causing factors complicating the situation. Periodontitis is treated by stopping the progression of the disease.
The earlier we detect and treat the disease, the easier the therapy is, and the person does not suffer from late complications of the disease, such as shaking and loss of teeth.
The primary treatment is always a conservative periodontal treatment: it consists of the removal of bacteria (biofilm) and changing the environment in which they develop. This is done in several sessions, according to the severity of inflammation (between 4 and 7 treatment sessions), over several consecutive weeks. After the conservative treatment, periodic controls are scheduled to reassess the situation. Comparative measurements of the depth of periodontal pockets and X-rays are taken to monitor the outcomes of the treatment.
The entire clinical team – Dr. Shuleva, Dr. Yakimova, the nurses and assistants –
is involved in the conservative treatment.
A surgical periodontal treatment is scheduled if a bone correction that requires filling of the bone pockets with bone replacement, etc., is needed.
- The surgical periodontal treatment follows the primary treatment of the patient. To operate, the disease must be under control so that the environment and conditions in the oral cavity are compatible with periodontal health. Surgical techniques are numerous and are individually planned and explained to every patient. The postoperative period, which includes the last 2 to 3 weeks during which the patient has individual guidance and check-ups, is extremely important for the outcomes of the operation.
Dr. Shuleva performs all periodontal surgeries.
Cured patients, who want to be active partners in the treatment, undergo a supportive periodontal therapy, which is the third stage of periodontal treatment.
- Maintenance therapy is performed on an individual plan in 3, 4, 6 or 9 months. After each consecutive check-up, the patient is given individual recommendations and scheduled next period of healing support.
In the periodontal maintenance treatment of patients participates the entire clinical team: Dr. Shuleva,&nbsp; Dr. Yakimova, the nurses and assistants.
Over the years, Dr. Shuleva has accepted for consultation and treatment more than 3,600 people.
Problems with exposed teeth are a frequent reason for dental consultation. The patient notices how the gum pulls away and gradually reveals the root. It is very important to explain to the patient the diagnosis and the progression of the condition. If the patient is healthy (no Gingivitis or Periodontitis), this is a "state," not a disease, and it depends mostly on the person’s bite. The teeth that become exposed often grow outwardly in the jaw where the external part of the root is outside the bone, covered with a crown. Hard clenching over the years, hard scrub with a stiff brush, and the use of very acidic and carbonated foods and beverages affect the uncovering of the crown, with or without, affecting the roots ("cervical cavities").
Many poor habits intensify this problem: excessive gum chewing, eating seeds with front teeth, biting nails (onychophagia), cuticles, and hand-grip pencils, sticks, and so on; biting of pipes or electronic cigarette holders, electronic cigarettes, etc., with the front teeth, and more. When the baring is small, prevention is sufficient to limit development. When the baring is significant and leads to aesthetic and functional problems, a plan treatment through periodontal plastic surgery (different grafting techniques for implanting crowns to cover the exposed roots) is suggested (Read more in publications).
Dr. Shuleva has over 15 years of experience in plastic periodontal surgery.
In patients with bared teeth who suffer from inflammation of the periodontium (Periodontitis or Gingivitis) the inflammatory disease is treated first, and then the prevention and treatment of the non-inflammatory disease (Periodontal recessions) is planned.&nbsp;